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2. Complete this form if you are interested in joining our Baby & You Program. Completing this form does not ensure enrollment into the program. Our Early Learning Coordinator will reach out to you with more information. 

   Attendance and engagement are important to the success of the program. Please double check your schedules and previous commitments to decide which cohort dates would work best for you and your family. 

4. Name
5. Email
7. Phone
8. Zip Code
10. Which cohort are you interested in?

    1. January 10, 2026 - March 7, 2026 (Saturdays)
    2. March 21, 2026 - June 6, 2026 (Saturdays)
    3. June 24, 2026 - August 15, 2026 (Wednesdays)
    4. September 12, 2026 - November 14, 2026 (Saturdays)
12. How did you hear about the Promise SSL Baby & You program?
14. Additional information about SSL's Personal Data Request Notice
    https://sslc.gov/DocumentCenter/View/2264/Personal-Data-Request-Notice---Citywide
16. Additional information about SSL's Personal Data Request Notice
    https://sslc.gov/DocumentCenter/View/2255/Personal-Data-Request-Notice---PSSL
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field